ACA Marketplace Take-Up Was High After Facilitated Enrollment In California; Disparities Remained.
During the unwinding of the continuous coverage requirements related to the COVID-19 public health emergency in 2023, as an unprecedented volume of consumers were transitioning out of Medicaid, California launched a facilitated enrollment program for people who lost Medicaid and were eligible for su...
| Published in: | Health Affairs Vol. 45; no. 8; pp. 934 - 943 |
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| Main Authors: | , , , , |
| Format: | research tables/charts Journal Article |
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Health Affairs Publishing, LLC
Aug2026
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=195900394&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 195900394 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 02782715 HAF jtl: Health Affairs issn: 02782715 maglogo: N pubinfo: dt: Aug2026 vid: 45 iid: 8 pid: 1453 pub: Health Affairs Publishing, LLC place: Washington, District of Columbia artinfo: ui: 195900394 195900394 195900394 10.1377/hlthaff.2025.01585 195900394 ppf: 934 ppct: 9 formats: tig: atl: ACA Marketplace Take-Up Was High After Facilitated Enrollment In California; Disparities Remained. aug: au: Hagen, Renée Wolf, Emory McCormick, Carolyn Menashe, Isaac Ravel, Katie affil: Covered California, Sacramento, California sug: subj: Patient Protection and Affordable Care Act Legislation and Jurisprudence Health Insurance Exchanges Healthcare Disparities Medicaid Medically Uninsured Eligibility Determination Sociodemographic Factors State Health Plans Human Male Female Adult Middle Age California Nonexperimental Studies Descriptive Research Comparative Studies T-Tests Chi Square Test Multiple Logistic Regression Self Employment Employment, Supported Health Status Citizenship Written Language Race Factors Ethnic Groups Age Factors Sex Factors Probability Confidence Intervals Post Hoc Analysis Power Analysis Educational Status Health Services Accessibility Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: During the unwinding of the continuous coverage requirements related to the COVID-19 public health emergency in 2023, as an unprecedented volume of consumers were transitioning out of Medicaid, California launched a facilitated enrollment program for people who lost Medicaid and were eligible for subsidized Marketplace coverage. We conducted a survey in 2023-24 to assess coverage outcomes among Californians who lost Medicaid coverage, were assigned to a default plan, and had thirty days to opt in to coverage under the program. Although national surveys indicate high rates of uninsurance after loss of Medicaid, we found that 85 percent of those who were eligible for an Affordable Care Act Marketplace subsidy had some form of health insurance. Among those without other available coverage, nearly two-thirds opted in to a Marketplace plan. People with a high school education or less were least likely to enroll in Covered California, as were those who rated their health status as poor. Even after we accounted for premium amounts, income, education, health status, and language preference, take-up was higher among Asian/Asian American (84 percent) and White (79 percent) people than among Hispanic/Latino (53 percent) and Black/African American (54 percent) people. Our findings indicate that facilitated enrollment interventions should be strengthened to overcome administrative and other burdens that persist among subpopulations. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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